Straight Therapists Working with Lesbians and Gays in Family Therapy

Bernstein, Anne C., Journal of Marital and Family Therapy

This article uses a cultural literacy model to sensitize straight marital and family therapists (MFTs) to work with gays, lesbians, and their families. While most MFTs number gays and lesbians among their clients, differences in sexual orientation between therapist and clients are often insufficiently addressed, closing off therapeutic possibilities. Marital and family therapists are asked to systematically assess homophobic and heterosexist assumptions in both personal attitudes and professional theory and practice and to educate themselves about gay culture and family life. The role of disclosure, trust, and collaborative meaning making in creating a therapeutic relationship that is culturally sensitive, clinically effective, and ethically responsible is examined.

When therapist and client differ in sexual orientation, there is an initial sense of "otherness" that must be bridged in building a therapeutic relationship. Each needs to become aware of the panoply of assumptions, inferences, and emotions that adhere to the image of the other, both as an actual individual and as a representative of another culture. Each must also assess how he or she is perceived by the other, differentiating how one sees oneself from how one is defined by the larger culture. The shared experience of the therapeutic encounter sensitively negotiated-the "intimate interaction" that Weingarten (1992, p. 45) defines as occurring "when people share meaning or co-create meaning"-bridges that otherness, creating connection without obliterating difference. This article will address how straight marital and family therapists (MFTs) can bridge differences in sexual orientation to work effectively with gay and lesbian families and couples.

THE CULTURAL LITERACY MODEL

To be effective in working with clients whose cultural background differs from one's own, it is widely accepted that a therapist needs to become culturally literate, developing familiarity with the client's heritage and milieu. This includes being aware of the "power differentials in society and the ways that they may affect the therapy process and the client's day to day life" (Greene, 1995, p. 155). This is no less true when these differences revolve around sexual orientation than when they concern race, ethnicity, or social class. Straight MFTs working with gays and lesbians must be willing to examine themselves, their own privilege as heterosexuals, and their attitudes, feelings, and beliefs about gay, lesbian, bisexual, and transgender people. They also need to adopt a cross-cultural perspective in working therapeutically with those whose sexual orientation differs from their own. (The use of the terms gay and lesbian to discuss how culture is constructed along lines of sexual orientation is not meant to exclude bisexuals or transgender people; it is used only to avoid the unwieldy prose that would follow from the more inclusive list.)

This article advocates a cultural literacy model for straight MFTs working with gays and lesbians and their families, exploring the gains and losses accruing to similarity or difference in sexual orientation between therapist and clients. It invites straight therapists to challenge homophobic and heterosexist biases, both in their personal attitudes and in the theoretical assumptions of their preferred clinical models, and offers directions for self education to increase cultural competence. The article concludes with a discussion of how to build trust between straight therapists and gay clients, how to handle issues of secrecy and openness, and how to collaboratively create meaning so as to realize clients' therapeutic objectives.

Not a Specialty Practice

The majority of MFTs (80%o of the 454 American Association for Marriage and Family Therapy [AAMFT] members sampled by Green & Bobele,1994) work with gay and lesbian clients. This is probably an underestimation because "adolescents, married persons, some parents who fear loss of child custody, and elderly clients who grew up in more repressive times may never reveal their homosexual or bisexual orientations to their therapists" (Green, 1996, p. …

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